From the Divisions of Cardiology (P.M.R.) and Preventive Medicine
(P.M.R., J.E.B., C.H.H.), Brigham and Women's Hospital, and the
Department of Ambulatory Care and Prevention (J.E.B., C.H.H.), Harvard Medical
School, Boston, Mass; and Abbott Laboratories, Abbott Park, Ill (M.M., J.S.).
Correspondence to Paul M. Ridker, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. E-mail pmridker{at}bics.bwh.harvard.edu
Abstract
Background—C-reactive protein (CRP)
predicts risk of myocardial infarction (MI) and stroke among apparently
healthy men, but in women, virtually no data are available.
Methods and Results—CRP was measured in baseline blood samples
from 122 apparently healthy participants in the Women's Health Study
who subsequently suffered a first cardiovascular event
and from 244 age- and smoking-matched control subjects who remained
free of cardiovascular disease during a 3-year
follow-up period. Women who developed cardiovascular
events had higher baseline CRP levels than control subjects
(P=0.0001), such that those with the highest levels at
baseline had a 5-fold increase in risk of any vascular event (RR=4.8;
95% CI, 2.3 to 10.1; P=0.0001) and a 7-fold increase in
risk of MI or stroke (RR=7.3; 95% CI, 2.7 to 19.9;
P=0.0001). Risk estimates were independent of other risk
factors, and prediction models that included CRP provided a better
method to predict risk than models that excluded CRP (all
P values <0.01). In stratified analyses, CRP
was a predictor among subgroups of women with low as well as high risk
as defined by other cardiovascular risk factors.
Conclusions—In these prospective data among women, CRP is a
strong independent risk factor for cardiovascular
disease that adds to the predictive value of risk models based on usual
factors alone.
© 1998 American Heart Association, Inc.
Brief Rapid Communication
Prospective Study of C-Reactive Protein and the Risk of Future Cardiovascular Events Among Apparently Healthy Women
Key Words: C-reactive protein • inflammation • cardiovascular diseases
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